South Africa

In South Africa, MSF continues to develop new testing and treatment strategies for HIV and tuberculosis (TB).

South Africa, home to over 50 million people, has one of the continent's biggest and most developed economies.

Until 1994 it was ruled by a white minority which enforced a separation of races with its policy of apartheid.

The apartheid government eventually negotiated itself out of power after decades of international isolation, armed opposition and mass protests.

The democratically-elected leadership encouraged reconciliation and set about redressing social imbalances.

Médecins Sans Frontières/Doctors Without Borders (MSF) has worked in South Africa since 1999, caring for tuberculosis (TB) and HIV/AIDS patients. 

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MSF's work in South Africa: 2018

In South Africa, Médecins Sans Frontières (MSF) supports innovations for change in HIV and tuberculosis (TB) treatment, care for victims of sexual violence and access to lifesaving drugs. 

In 2018, South Africa became the first country in the world to make the oral drug bedaquiline part of its standard recommended treatment for drug-resistant TB (DR-TB), helping to phase out painful, toxic injections and scale up access to more effective, more tolerable treatments – a long-standing MSF goal. 


HIV and TB treatment We are working to increase access to new and repurposed drugs and community-based care for patients with DR-TB through our HIV and TB projects in Khayelitsha, near Cape Town, and King Cetshwayo district, KwaZulu-Natal, while supporting efforts to reach the UNAIDS 90-90-90 targets for people living with HIV.*

In 2018, we conducted a door-to-door HIV survey through our project in King Cetshwayo district. The preliminary results endorsed the innovative community-based strategies we have implemented since 2011 to reduce HIV and TB incidence, sickness and mortality. In 2018, 22,780 people were tested in the community for HIV and 1,280 were started on TB treatment, including 220 on bedaquiline and/or delamanid. 

In Khayelitsha, we enrolled 198 mother and baby pairs in postnatal support clubs, designed to improve care for women with HIV and their HIV-exposed infants. The programme was piloted in 2016 and incorporated into the national HIV treatment guidelines a year later. 

South Africa also became part of the multi-country endTB clinical trial aiming to find shorter, less toxic and more effective treatment regimens for multidrug-resistant TB (MDR-TB). We launched the trial in Khayelitsha in May and had enrolled 28 patients by the end of the year. 


Care for victims of sexual violence

In Bojanala district, in South Africa’s platinum mining belt, we are helping to expand access to care for victims of sexual and genderbased violence through four dedicated clinics, known as Kgomotso Care Centres, which offer medical and mental healthcare, and social services. An increasing number of patients are being referred from communitybased initiatives, including a school health programme, through which we conducted education sessions reaching 12,670 pupils in 20 schools. Around 27 pupils a month were referred to our care centres in 2018. 

We also continue to support termination of pregnancy services for women who request them. Two MSF nurses performed 90 to 100 procedures a month in two community health centres in 2018. 

Stop Stockouts Project (SSP) 

The SSP is a civil society consortium supported by MSF and five other organisations, which monitors the availability of essential drugs in clinics across the country and pushes for the rapid resolution of stockouts and shortages. In 2018, the SSP helped to identify and raise awareness of stockouts across North West province resulting from health worker strike action.

*The globally agreed 90-90-90 targets require that 90 per cent of people living with HIV know their status, that 90 per cent of people living with HIV initiate and remain on ARV treatment, and that 90 per cent of people on ARV treatment reach and maintain an undetectable viral load by 2020.


“For 29 years I endured physical and mental abuse at the hands of my husband. I stayed with him because in our culture, we respect the wishes of our parents, and my mother felt it would humiliate her if I left him. In 2014 and 2015 I lost my mother, sister and brother, and my life fell apart – I could no longer face my home but had nowhere else to go.

On the streets of Boitekong I had met a healthcare worker called Rosina from MSF, who told me about the services for victims of partner violence at the Kgomotso care centre at Boitekong community health centre. I borrowed 20 rand (US$1.70), and took a taxi to the centre, where I was counselled and then transported to a shelter for vulnerable women and children.

I feel strong now, and ready to leave the shelter. If an abused woman hears my story, I want her to know that I used to hide my problems, but if you don’t seek help it can kill you from inside. Getting to a clinic and talking to a counsellor saved my life.”

find out more in our international activity report >

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